Alomari Omar, Karaçelik Arzu, Rana Tatar Elif, Ulya Durmus Betul, Keskin Ozcan
Medicine and Surgery, Hamidiye International Faculty of Medicine, University of Health Sciences, Istanbul, TUR.
Internal Medicine, Kartal State Hospital, Istanbul, TUR.
Cureus. 2024 Jul 28;16(7):e65612. doi: 10.7759/cureus.65612. eCollection 2024 Jul.
Celiac disease (CD) is a systemic autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals and characterized by diverse clinical presentations. Despite its prevalence, CD often remains undiagnosed due to its heterogeneous symptoms and inadequate awareness. Here, we present a case of a 42-year-old male with gastritis who presented with epigastric discomfort and pancytopenia. Initial investigations revealed a hemoglobin level of 3.7 g/dL, a mean corpuscular volume (MCV) of 84 fL, a white blood cell count (WBC) of 2420 cells/μL, a neutrophil count (NEU) of 1400 cells/μL, and a platelet count (PLT) of 140,000 cells/μL. A diagnostic workup revealed evidence of CD, and after that, the diagnosis was confirmed by gastro-colonoscopy. The patient's subsequent adherence to a gluten-free diet resulted in significant clinical improvement. Notably, during follow-up appointments, a notable change in the patient's hair color was observed, prompting further inquiry. The patient reported experiencing premature graying of hair during his late thirties, which remained unchanged until the diagnosis of CD and the initiation of a gluten-free diet. This unique manifestation highlights the potential association between CD and premature graying of the hair, warranting further investigation. While the precise mechanism remains unclear, it is plausible that CD-induced malabsorption and nutritional deficiencies may contribute to such changes. Therefore, we advocate for increased awareness and international collaboration to enhance understanding of this phenomenon and its implications for CD management. This case underscores the importance of early diagnosis and management of CD, as well as the potential for dietary interventions to alleviate associated symptoms and complications.
乳糜泻（CD）是一种系统性自身免疫性疾病，由遗传易感个体摄入麸质引发，具有多种临床表现。尽管其发病率较高，但由于症状异质性和认知不足，CD常未被诊断出来。在此，我们报告一例42岁患有胃炎的男性病例，该患者出现上腹部不适和全血细胞减少。初步检查显示血红蛋白水平为3.7 g/dL，平均红细胞体积（MCV）为84 fL，白细胞计数（WBC）为2420个细胞/μL，中性粒细胞计数（NEU）为1400个细胞/μL，血小板计数（PLT）为140,000个细胞/μL。诊断性检查发现了CD的证据，之后通过胃肠镜检查确诊。患者随后坚持无麸质饮食，临床症状显著改善。值得注意的是，在随访预约期间，观察到患者头发颜色有明显变化，促使进一步询问。患者报告在三十多岁后期头发过早变白，在CD诊断和开始无麸质饮食之前一直未变。这种独特表现突出了CD与头发过早变白之间的潜在关联，值得进一步研究。虽然确切机制尚不清楚，但CD引起的吸收不良和营养缺乏可能导致这种变化似乎是合理的。因此，我们主张提高认识并开展国际合作，以增进对这一现象及其对CD管理影响的理解。该病例强调了CD早期诊断和管理的重要性，以及饮食干预缓解相关症状和并发症的潜力。
